NAC 630.010Definitions. (NRS 630.130)As used
in this chapter, unless the context otherwise requires, the words and terms
defined in NRS 630.005 to 630.026, inclusive, and NAC 630.025 have the meanings ascribed to them in
those sections.

NAC 630.025“Controlled substance” defined. (NRS 630.130)“Controlled
substance” has the meaning ascribed to it in NRS 0.031.

(Added to NAC by Bd. of Medical Exam’rs by R007-99,
eff. 9-27-99)

NAC 630.040“Malpractice” interpreted. (NRS 630.130)For the
purposes of chapter 630 of NRS,
“malpractice” means the failure of a physician, in treating a patient, to use
the reasonable care, skill, or knowledge ordinarily used under similar
circumstances.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96)—(Substituted
in revision for NAC 630.245)

NAC 630.043“State” interpreted. (NRS 630.130, 630.266)For the
purposes of NRS 630.266 and NAC 630.147 and 630.149,
the Board will interpret the term “state,” when referring to a state other than
this State, to mean a state of the United States other than Nevada, the
District of Columbia, Puerto Rico, the United States Virgin Islands, or any
territory or insular possession subject to the jurisdiction of the United
States.

1. Any document submitted to the Board by a
licensee or an applicant for a license to practice medicine, to practice as a
physician assistant, to practice as a practitioner of respiratory care or to
practice as a perfusionist must bear the original signature of the licensee or
applicant.

2. The Board may refuse to accept any
document submitted by a licensee or an applicant for a license that does not
bear the original signature of the licensee or applicant.

3. As used in this section, “document” means
any written submission, notification or communication, including, without
limitation:

(a) An application for a license;

(b) A request for renewal of a license;

(c) A request for a change of status; or

(d) A notification of a change of address.

(Added to NAC by Bd. of Medical Exam’rs by R006-07,
eff. 10-31-2007; A by R061-11, 5-30-2012)

1. The Board will not accept any application
for any type of license to practice medicine in this State if the Board cannot
substantiate that the medical school from which the applicant graduated
provided the applicant with a resident course of professional instruction
equivalent to that provided in the United States or a Canadian medical school
approved by either the Liaison Committee on Medical Education of the American
Medical Association and the Association of American Medical Colleges or by the
Committee on Accreditation of Canadian Medical Schools.

2. Except as otherwise provided in NAC 630.130, an applicant for any license to practice
medicine must file his or her sworn application with the Board. The application
must include or indicate the following:

(a) If the applicant is not a citizen of the United
States, satisfactory evidence from the United States Citizenship and
Immigration Services of the Department of Homeland Security that he or she is
lawfully entitled to remain and work in the United States.

(b) All documentation required by the application.

(c) Complete answers to all questions on the form.

3. The application must be accompanied by
the applicable fee.

4. If the Board denies an application for
any type of license to practice medicine in this State, the Board may prohibit
the person whose application was denied from reapplying for a period of 1 year
to 3 years after the date of the denial.

NAC 630.055Qualifications: “Progressive postgraduate education” interpreted.
(NRS
630.130, 630.160)As used
in paragraph (d) of subsection 2 of NRS
630.160, the term “progressive postgraduate education” does not include
training received in the program commonly referred to as the “fifth pathway
program,” which was established by the American Medical Association in 1971 to
allow entry into the first year of graduate medical education in the United
States to citizens of the United States who study at foreign medical schools.

(Added to NAC by Bd. of Medical Exam’rs by R007-99,
eff. 9-27-99; A by R145-03, 12-16-2003)

1. For the purposes of paragraph (e) of
subsection 2 of NRS 630.160, an
applicant for a license to practice medicine must pass:

(a) A written examination concerning the statutes
and regulations relating to the practice of medicine in this State; and

(b) Except as otherwise provided in subsection 2,
an examination, designated by the Board, to test the competency of the
applicant to practice medicine, including, without limitation:

(1) The Special Purpose Examination;

(2) An examination testing competence to
practice medicine conducted by physicians; or

(3) Any other examination designed to test the
competence of the applicant to practice medicine.

2. The Board will deem an applicant to have
satisfied the requirements of paragraph (b) of subsection 1 if:

(a) Within 10 years before the date of an application
for a license to practice medicine in this State, the applicant has passed:

(1) Part III of the examination given by the
National Board of Medical Examiners;

(2) Component II of the Federation Licensing
Examination;

(3) Step 3 of the United States Medical
Licensing Examination;

(4) All parts of the examination to become a
licentiate of the Medical Council of Canada;

(5) The examination for primary certification
or recertification by a specialty board of the American Board of Medical
Specialties and received primary certification from that board; or

(6) The Special Purpose Examination; or

(b) The applicant is currently certified and was
certified prior to recertification or maintenance of certification requirements
by a specialty board of the American Board of Medical Specialties, agrees to
maintain that certification throughout any period of licensure in this State
and has actively practiced clinical medicine for the past 5 years in any state
in which the applicant is licensed.

3. For the purposes of subparagraph (3) of
paragraph (c) of subsection 2 of NRS
630.160:

(a) An applicant for a license to practice medicine
must pass Step 1, Step 2 and Step 3 of the United States Medical Licensing
Examination in not more than a total of nine attempts and must pass Step 3 in
not more than a total of three attempts; and

(b) An applicant:

(1) Who holds a degree of doctor of medicine
must pass all steps of the examination within 7 years after the date on which
the applicant first passes any step of the examination; or

(2) Who holds a degree of doctor of medicine
and a degree of doctor of philosophy must pass all steps of the examination
within 10 years after the date on which the applicant first passes any step of
the examination.

4. For any examination conducted by the
Board for a license to practice medicine, an applicant must answer correctly at
least 75 percent of the questions propounded. The Board will use the weighted
average score of 75, as determined by the Federation of State Medical Boards of
the United States, Inc., to satisfy the required score of 75 percent for
passage of the Special Purpose Examination and the United States Medical
Licensing Examination.

5. The Board will authorize the Federation
of State Medical Boards of the United States, Inc., to administer the Special
Purpose Examination or the United States Medical Licensing Examination on
behalf of the Board.

6. An applicant for a license to practice
medicine and a person who holds a license to practice medicine must pay the
reasonable costs of any examination required for licensure and any examination
ordered pursuant to NRS 630.318.

1. The applicant for a limited license to
practice medicine as a resident physician in a graduate program of clinical
training must file an application with the Board on the standard form for
application for a license to practice medicine and submit with the application
such proofs and documents as are required on the form to the extent that the
proofs and documents are applicable to the issuance of the limited license.

2. The application must be accompanied by
written confirmation from the institution sponsoring the graduate program of
clinical training that the applicant has been appointed to a position in the
program. If the applicant is not a citizen of the United States, the applicant
must also provide satisfactory evidence from the United States Citizenship and
Immigration Services of the Department of Homeland Security that he or she is
lawfully entitled to remain and work in the United States.

3. The Board will review the application
and, upon approval, issue the limited license. An applicant for a limited
license may be required to appear before the Board or one of its members for an
oral interview before the issuance of the limited license.

4. A limited license issued under this
section will state on its face that it is a limited license to practice
medicine as a resident physician in a graduate program of clinical training,
and the period during which it is valid. If the licensee is not a citizen of
the United States, a limited license is valid only as long as the licensee is
lawfully entitled to remain and work in the United States.

NAC 630.135Renewal of limited license for graduate program of training;
annual report required; grounds for disciplinary action or denial or revocation
of license. (NRS
630.130, 630.265)

1. A resident physician who wishes to renew
a limited license to practice medicine as a resident physician in a graduate
program of clinical training must file an application for renewal with the
Board.

2. The application must be:

(a) Completed by the applicant; and

(b) Certified by the director of the program of
clinical training.

3. As a condition of renewal of a limited
license to practice medicine as a resident physician in a graduate program of
clinical training, the licensee shall submit an annual report signed by the
director of the program of clinical training that has been:

(a) Submitted on a form supplied by the Board; and

(b) Signed by the chair of the Graduate Medical
Education Committee.

4. The holder of a limited license may be
disciplined if information supplied to the Board by the director of the program
of clinical training constitutes grounds for:

5. The Board may deny the application for
any of the reasons set forth as grounds for the denial of a license to practice
medicine pursuant to NRS 630.200.

(Added to NAC by Bd. of Medical Exam’rs by R149-97,
eff. 3-30-98; A by R108-01, 11-29-2001)

NAC 630.145Restricted license: “Medically underserved area” defined. (NRS 630.130, 630.264)For the
purposes of subsection 1 of NRS
630.264, “medically underserved area” means any geographic area designated
by the Board with a population to primary care physician ratio of 2,500:1. When
designating a geographic area as medically underserved, the Board may consider
any additional criteria proposed by the Officer of Rural Health of the
University of Nevada School of Medicine or a board of county commissioners.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)—(Substituted in revision for NAC 630.035)

NAC 630.147Special event license to demonstrate medical techniques and
procedures: Application. (NRS 630.130, 630.266, 630.268)An
applicant for a special event license issued pursuant to NRS 630.266 must, not later than 30
days before the requested effective date described in subsection 1, submit to
the Board or, where appropriate, cause to be submitted to the Board:

1. An application for a special event
license on a form approved by the Board. The application must include, without
limitation, the date on which the applicant wishes the special event license to
become effective. To ensure compliance with NRS 630.266, the application must
also include:

(a) Verification that the applicant is currently
licensed as a physician in another state and is in good standing in that state;

(b) The dates and locations of the demonstrations
of medical techniques or procedures that the applicant plans to conduct
pursuant to the special event license; and

(c) A description of the type of persons expected
to attend the demonstrations.

2. The documentation and information, other
than an application, that an applicant for a license to practice medicine is
required to submit to the Board pursuant to NRS 630.165 to 630.173, inclusive, 630.195 and 630.197.

3. The applicable fee for the application
for and issuance of the special event license as prescribed by the Board
pursuant to subsection 1 of NRS
630.268.

1. If the Board issues a special event
license pursuant to NRS 630.266,
the Board will provide the period for which the special event license is valid.
The period of validity will not exceed 15 days after the effective date of the
special event license as established by the Board.

2. A holder of a special event license
issued pursuant to NRS 630.266
may, pursuant to the special event license:

(a) Conduct only those demonstrations of medical
techniques or procedures approved by the Board; and

(b) Conduct those demonstrations only on the dates
and at the locations approved by the Board.

1. Except as otherwise provided in
subsection 2 and NAC 630.157, each holder of a
license to practice medicine shall, at the time of the biennial registration,
submit to the Board by the final date set by the Board for submitting
applications for biennial registration evidence, in such form as the Board
requires, that he or she has completed 40 hours of continuing medical education
during the preceding 2 years in one or more educational programs, 2 hours of
which must be in medical ethics and 20 hours of which must be in the scope of
practice or specialty of the holder of the license. Each educational program
must:

(a) Offer, upon successful completion of the
program, a certificate of Category 1 credit as recognized by the American
Medical Association to the holder of the license;

(b) Be approved by the Board; and

(c) Be sponsored in whole or in part by an
organization accredited or deemed to be an equivalent organization to offer
such programs by the American Medical Association or the Accreditation Council
for Continuing Medical Education.

2. Any holder of a license who has completed
a full year of residency or fellowship in the United States or Canada any time
during the period for biennial registration immediately preceding the
submission of the application for biennial registration is exempt from the
requirements set forth in subsection 1.

3. If the holder of a license fails to
submit evidence of his or her completion of continuing medical education within
the time and in the manner prescribed by subsection 1, the license will not be
renewed. Such a person may not resume the practice of medicine unless, within 2
years after the end of the biennial period of registration, the person:

(a) Pays a fee to the Board which is twice the fee
for biennial registration otherwise prescribed by subsection 1 of NRS 630.268;

(b) Submits to the Board, in such form as it
requires, evidence that he or she has completed 40 hours of Category 1
continuing medical education as recognized by the American Medical Association
within the preceding 2 years; and

(c) Is found by the Board to be otherwise qualified
for active status pursuant to the provisions of this chapter and chapter 630 of NRS.

4. The Board may issue up to 20 hours of
continuing medical education credit during a single biennial period to a holder
of a license to practice medicine if the licensee performs a medical review for
the Board. The hours issued by the Board:

(a) May be credited against the 40 hours required
for any single biennial registration period pursuant to subsection 1; and

(b) Without exceeding the limit of 20 hours, must
be equal to the actual time involved in performing the medical review.

1. Pursuant to the provisions of NRS 630.253, a holder of a license
to practice medicine shall complete a course of instruction relating to the
medical consequences of an act of terrorism that involves the use of a weapon
of mass destruction:

(a) If the holder of a license to practice medicine
was initially licensed by the Board on or after October 1, 2003, within 2 years
of initial licensure.

(b) If the holder of a license to practice medicine
was initially licensed by the Board before October 1, 2003, on or before
September 30, 2005.

2. In addition to the requirements provided
pursuant to NRS 630.253, a
course of instruction relating to the medical consequences of an act of terrorism
that involves the use of a weapon of mass destruction:

(a) Except as otherwise provided in subsection 3,
must offer, upon successful completion of the program, a certificate of
Category 1 credit as recognized by the American Medical Association to the
holder of the license; and

(b) Is in addition to the continuing education
required pursuant to NAC 630.153.

3. A course of instruction relating to the
medical consequences of an act of terrorism that involves the use of a weapon
of mass destruction will be deemed to satisfy the requirements of paragraph (a)
of subsection 2 if the course was provided to a holder of a license to practice
medicine:

(a) After January 1, 2002; and

(b) As a part of the training the holder of the
license to practice medicine received:

1. Except as otherwise provided in
subsection 2, if a holder of a license to practice medicine takes a continuing
education class on geriatrics and gerontology, the holder is entitled to
receive credit towards the continuing medical education required pursuant to NAC 630.153 equal to twice the number of hours the
holder of the license actually spends in a continuing education class on
geriatrics and gerontology.

2. During any biennial licensing period, a
holder of a license to practice medicine may receive a maximum credit pursuant
to subsection 1 of 8 hours of continuing medical education for 4 hours of time
spent in a continuing education class on geriatrics and gerontology.

3. As used in this section, “continuing
education class on geriatrics and gerontology” means a class that meets the
requirements of:

(b) For a continuing education class on geriatrics
and gerontology, NRS 630.253.

(Added to NAC by Bd. of Medical Exam’rs by R145-03,
eff. 12-16-2003)

NAC 630.157Continuing education: Licensing after beginning of period of
biennial registration; change of status to active. (NRS 630.130, 630.253)

1. Except as otherwise provided in NAC 630.153, each person licensed after the beginning
of a period of biennial registration must, if he or she was licensed during the:

(a) First 6 months of the biennial period of
registration, complete 40 hours of Category 1 continuing medical education as
recognized by the American Medical Association;

(b) Second 6 months of the biennial period of
registration, complete 30 hours of Category 1 continuing medical education as
recognized by the American Medical Association;

(c) Third 6 months of the biennial period of
registration, complete 20 hours of Category 1 continuing medical education as
recognized by the American Medical Association; or

(d) Fourth 6 months of the biennial period of
registration, complete 10 hours of Category 1 continuing medical education as
recognized by the American Medical Association.

2. An applicant who applies to change his or
her status to active status must provide proof of completion of 40 hours of
Category 1 continuing medical education as recognized by the American Medical
Association within the 24 months immediately preceding such an application.

NAC 630.162Temporary license: “Community” interpreted. (NRS 630.130, 630.261)As used
in paragraph (d) of subsection 1 of NRS
630.261, “community” means a geographical area or patient service area
served by an agency of the State Government.

1. Ascribed to it by the jurisdiction in
which the license was revoked; or

2. Ascribed to a term which the Board determines
to be substantially similar to “gross medical negligence” by the jurisdiction
in which the license was revoked.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96)

NAC 630.170Termination of license issued to alien. (NRS 630.130)A
license issued to an alien automatically terminates if the alien loses his or
her entitlement to remain and work in the United States. A license issued to an
alien after March 15, 1999, must state in a conspicuous manner:

This license is issued subject to any
limitations imposed by the United States Citizenship and Immigration Services
of the Department of Homeland Security. This license becomes void immediately
upon the termination of the right of the person named hereon to remain and work
in the United States lawfully.

NAC 630.175Fee for biennial registration: Payment; refund. (NRS 630.130, 630.267)Unless
the license has expired for nonpayment of the fee for registration, any person
licensed to practice by the Board after July 1 of the second year of a period
of biennial registration shall pay one-half of the fee for biennial
registration for the current period of biennial registration. Any person
licensed to practice by the Board after commencement of a period of biennial
registration, but on or before July 1 of the second year of a period of
biennial registration, shall pay the full fee for biennial registration. Except
as otherwise provided by specific regulation, the fees for biennial
registration are not refundable.

NAC 630.178Change in status of license after expiration for nonpayment of
fee. (NRS
630.130, 630.267)If a
person whose license to practice medicine expired pursuant to NRS 630.267 for nonpayment of the
fee for biennial registration wishes to change the status of his or her license
from active to inactive or from inactive to active, the person must, within 2
years after the date on which the license expired, submit:

1. Twice the amount of the fee for biennial
registration applicable to the status of his or her license at the time of the
expiration; and

2. Any other information or documentation
required to complete that biennial registration.

(Added to NAC by Bd. of Medical Exam’rs by R002-06,
eff. 5-21-2007; A by R136-11, 9-14-2012)

(a) Does not complete his or her application by
providing all the documentation required by the form for application within 6
months after the actual date of filing of the form by the applicant;

(b) Withdraws his or her application; or

(c) Dies before he or she is issued a license by
the Board,

Ê the Board
will not refund any portion of the fee for application.

2. Applications which are not completed
within 6 months will be rejected.

3. If an applicant pays the fee for biennial
registration at the time of application, the Board will refund the fee for
biennial registration if the Board does not issue a license to the applicant
for any reason set forth in subsection 1 or 2.

NAC 630.187Adoption by reference of Model Policy for the Use of
Controlled Substances for the Treatment of Pain. (NRS 630.130, 630.275)

1. The Board hereby adopts by reference the Model
Guidelines for the Use of Controlled Substances for the Treatment of Pain,
May 1998, published by the Federation of State Medical Boards of the United
States, Inc., titled the Model Policy for the Use of Controlled Substances
for the Treatment of Pain for revisions published after April 2003, and any
subsequent revision of the publication that has been approved by the Board for
use in this State. Each revision of the publication shall be deemed approved by
the Board unless it disapproves of the revision within 60 days after the date of
publication of the revision.

2. The most recent publication of the Model
Policy for the Use of Controlled Substances for the Treatment of Pain
that has been approved by the Board will be available for inspection at the
office of the Board of Medical Examiners, 1105 Terminal Way, Suite 301, Reno,
Nevada 89502, or may be obtained, free of charge, from the Federation of State
Medical Boards of the United States, Inc., Federation Place, 400 Fuller Wiser
Road, Suite 300, Euless, Texas 76039-3855, or from the Federation of State
Medical Boards of the United States, Inc., at the Internet address http://www.fsmb.org.
The Board shall:

(a) Review each revision of the publication to
ensure its suitability for this State; and

(b) File a copy of each revision of the publication
it approves with the Secretary of State and the State Library and Archives
Administrator.

(Added to NAC by Bd. of Medical Exam’rs by R089-00,
eff. 7-19-2000; A by R059-11, 5-30-2012)

1. A licensee shall not advertise in such a
manner that the advertising:

(a) Claims that a manifestly incurable disease can
be permanently cured;

(b) Includes any false claim of a licensee’s
medical skill, or the efficacy or value of his or her medicine or treatment;

(c) Claims or implies professional superiority of
the performance of any professional service in a manner superior to that of
other practitioners;

(d) Guarantees any professional service or the
results of any course of treatment or surgical procedure, or the performance of
any operation painlessly;

(e) Includes any statement which is known to be
false, or through the exercise of reasonable care should be known to be false,
deceptive, misleading or harmful, in order to induce any person to purchase,
utilize or acquire any professional services or to enter into any obligation or
transaction relating thereto;

(f) Includes any extravagant claim, aggrandizement
of abilities or self-laudatory statement calculated to attract patients, and which
has a tendency to mislead the public or produce unrealistic expectations in
particular cases; or

(g) Is false, deceptive or misleading in regard to
the price, cost, charge, fee or terms of credit or services performed or to be
performed.

2. It is sufficient for disciplinary
purposes that any statement or other advertising described in paragraph (e),
(f) or (g) of subsection 1 has a tendency to:

(a) Deceive, mislead or harm the public because of
its false, deceptive, misleading or harmful character; or

(b) Produce unrealistic expectations in particular
cases, even though no member of the public is actually deceived, misled or
harmed, or no unrealistic expectations are actually produced by the statement
or other advertising.

1. A physician or physician assistant who is
authorized to prescribe controlled substances may prescribe an appetite
suppressant to control the weight of a patient if the appetite suppressant is
prescribed for use in the treatment of exogenous obesity as part of a program
of medical treatment which includes dietary restrictions, modification of
behavior and exercise and:

(a) The physician or physician assistant determines
that the patient’s obesity represents a threat to the patient’s health; or

(b) The patient’s weight exceeds by not less than
20 percent the upper limit of the patient’s healthy weight as set forth in
Figure 3 of Nutrition and Your Health: Dietary Guidelines for Americans,
fourth edition, published jointly by the United States Department of Health and
Human Services and Department of Agriculture, which the Board hereby adopts by
reference. A copy of the publication may be obtained from the Consumer
Information Center, Department 378-C, Pueblo, Colorado 81009, for the cost of
$0.50.

2. A physician or physician assistant shall
not prescribe an appetite suppressant for more than 3 months, unless the
patient:

(a) Has lost an average of not less than 2 pounds
per month since he or she began taking the appetite suppressant; or

(b) Has maintained his or her weight at the level
which was established by the patient’s physician or a physician assistant under
the supervision of his or her physician.

3. A physician or physician assistant who
prescribes an appetite suppressant for more than 3 months shall maintain a
record of the patient’s weight at the beginning and end of each month during
which the patient takes the appetite suppressant.

4. Before prescribing an appetite
suppressant, a physician or physician assistant shall obtain a medical history
and perform a physical examination of the patient and conduct appropriate
studies to determine if there are any contraindications to the use of the
appetite suppressant by the patient.

5. As used in this section, “appetite
suppressant” means a drug or other substance listed in schedule IV pursuant to NAC 453.540 which is used to suppress the
appetite of a natural person.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96;
A by R108-01, 11-29-2001)

NAC 630.210Consultation with another provider of health care. (NRS 630.130)A
physician shall seek consultation with another provider of health care in
doubtful or difficult cases whenever it appears that consultation may enhance
the quality of medical services.

[Bd. of Medical Exam’rs, § 630.210, eff. 12-20-79]—(NAC
A 6-23-86)

NAC 630.225Reporting of physician brought into this State for consultation
with or assistance to licensed physician. (NRS 630.130)

1. Any physician licensed in this State
shall notify the Board if any unlicensed physician comes into this State for
consultation with or assistance to the physician licensed in this State and
specify the date of the consultation or assistance, whether the unlicensed
physician has provided such consultation or assistance, or both, to the
licensed physician in the past, and the date of that consultation and
assistance.

2. A physician licensed in this State who
consults with or receives assistance from a physician licensed in another state
pursuant to subsection 1 shall comply with the provisions of chapter 629 of NRS governing the
preparation, retention or dissemination of any health care record resulting
from the consultation or assistance between the physician licensed in this
State and the physician licensed in another state.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86;
A by R045-09, 11-25-2009)

1. A person who is licensed as a physician
or physician assistant shall not:

(a) Falsify records of health care;

(b) Falsify the medical records of a hospital so as
to indicate his or her presence at a time when he or she was not in attendance
or falsify those records to indicate that procedures were performed by him or
her which were in fact not performed by him or her;

(c) Render professional services to a patient while
the physician or physician assistant is under the influence of alcohol or any
controlled substance or is in any impaired mental or physical condition;

(d) Acquire any controlled substances from any
pharmacy or other source by misrepresentation, fraud, deception or subterfuge;

(e) Prescribe anabolic steroids for any person to
increase muscle mass for competitive or athletic purposes;

(f) Make an unreasonable additional charge for
tests in a laboratory, radiological services or other services for testing
which are ordered by the physician or physician assistant and performed outside
his or her own office;

(g) Allow any person to act as a medical assistant
in the treatment of a patient of the physician or physician assistant, unless
the medical assistant has sufficient training to provide the assistance;

(h) Fail to provide adequate supervision of a
medical assistant who is employed or supervised by the physician or physician
assistant, including, without limitation, supervision provided in the manner
described in NAC 630.810 or 630.820;

(i) If the person is a physician, fail to provide
adequate supervision of a physician assistant or an advanced practice
registered nurse;

(j) Fail to honor the advance directive of a
patient without informing the patient or the surrogate or guardian of the patient,
and without documenting in the patient’s records the reasons for failing to
honor the advance directive of the patient contained therein; or

(k) Engage in the practice of writing prescriptions
for controlled substances to treat acute pain or chronic pain in a manner that
deviates from the policies set forth in the Model Policyfor
the Use of Controlled Substances for the Treatment of Pain adopted by
reference in NAC 630.187.

2. As used in this section:

(a) “Acute pain” has the meaning ascribed to it in
section 3 of the Model Policyfor the Use of Controlled
Substances for the Treatment of Pain adopted by reference in NAC 630.187.

(b) “Chronic pain” has the meaning ascribed to it
in section 3 of the Model Policyfor the Use of Controlled
Substances for the Treatment of Pain adopted by reference in NAC 630.187.

1. Each holder of a license to practice
medicine shall annually submit a report pursuant to NRS 630.30665, on a form to be
provided by the Board. The form must include, without limitation:

(a) The name of the licensee;

(b) The office address of the licensee;

(c) The office phone number of the licensee;

(d) The number and type of surgeries requiring
conscious sedation, deep sedation or general anesthesia performed by the
licensee at his or her office or any other facility, excluding any surgical
care performed:

(e) Information regarding the occurrence of any
sentinel event arising from the type of surgeries described in paragraph (d).

2. As used in this section:

(a) “Conscious sedation” means a minimally
depressed level of consciousness, produced by a pharmacologic or
nonpharmacologic method, or a combination thereof, in which the patient retains
the ability independently and continuously to maintain an airway and to respond
appropriately to physical stimulation and verbal commands.

(b) “Deep sedation” means a controlled state of
depressed consciousness, produced by a pharmacologic or nonpharmacologic
method, or a combination thereof, and accompanied by a partial loss of
protective reflexes and the inability to respond purposefully to verbal
commands.

(c) “General anesthesia” means a controlled state
of unconsciousness, produced by a pharmacologic or nonpharmacologic method, or
a combination thereof, and accompanied by partial or complete loss of
protective reflexes and the inability independently to maintain an airway and
respond purposefully to physical stimulation or verbal commands.

(d) “Sentinel event” means an unexpected occurrence
involving death or serious physical or psychological injury or the risk
thereof, including, without limitation, any process variation for which a
recurrence would carry a significant chance of serious adverse outcome. The
term includes loss of limb or function.

1. The failure of a holder of a license to
practice medicine to submit to the Board a report required pursuant to NRS 630.30665:

(a) In a timely manner; or

(b) In an accurate or complete manner if the holder
of the license knowingly misstates or misrepresents:

(1) The number or types of surgeries required
to be reported pursuant to that section or NAC 630.235;
or

(2) The occurrence or outcome of any
reportable sentinel events pursuant to those sections,

Ê constitutes
grounds for imposing an administrative penalty against the holder of the
license.

2. An administrative penalty imposed
pursuant to this section may include the imposition of an administrative fine
of not less than $100 or more than $1,000 and recovery by the Board of all
costs incurred by the Board because of the violation.

3. Repeated violations of this section are
subject to an administrative fine in the amount of $1,000 in addition to
recovery by the Board of all costs incurred by the Board because of the
violations.

4. Before imposing any administrative
penalty pursuant to this section, the Board will:

(a) Consider the totality of the circumstances
surrounding the matter;

(b) Consider all evidence before it relating to the
matter, including, without limitation, any intentional, volitional or
purposeful conduct engaged in by the holder of the license; and

(c) Determine by a preponderance of the evidence
that the applicable provisions of this section or NRS 630.30665 were violated.

5. The provisions of this section do not
prohibit the Board from initiating disciplinary action for a violation of any
other provision of this chapter or chapter
630 of NRS.

1. If a licensee desires to surrender his or
her license to practice medicine, the licensee shall submit to the Board a
sworn written statement of surrender of the license accompanied by delivery to
the Board of the actual license issued to him or her. The Board will accept or
reject the surrender of the license. If the Board accepts the surrender of the
license, the surrender is absolute and irrevocable and the Board will notify
any agency or person of the surrender and the conditions under which the
surrender occurred, as the Board considers advisable.

2. The voluntary surrender of a license or
the failure to renew a license does not preclude the Board from hearing a
complaint for disciplinary action made against the licensee.

[Bd. of Medical Exam’rs, § 630.240, eff. 12-20-79]—(NAC
A 6-23-86)

NAC 630.243Procedure for dealing with findings of exposure to human
immunodeficiency virus. (NRS 630.130, 630.269, 630.275)If a
committee conducting an investigation pursuant to NRS 630.311 becomes aware that the
physician, physician assistant, practitioner of respiratory care or
perfusionist who is subject to the investigation has tested positive for
exposure to the human immunodeficiency virus, the committee shall appoint a
group of specialists in the fields of public health and infectious diseases who
shall:

1. Review all the circumstances of the
practice of the physician, physician assistant, practitioner of respiratory
care or perfusionist; and

2. Advise the committee, in accordance with
the guidelines on “Health Care Workers Infected with HIV” established by the
Centers for Disease Control and Prevention, on the action, if any, the
committee should take concerning the physician, physician assistant,
practitioner of respiratory care or perfusionist.

(Added to NAC by Bd. of Medical Exam’rs by R007-99,
eff. 9-27-99; A by R108-01, 11-29-2001; R060-11, 5-30-2012)

NAC 630.251Grounds: “Gross malpractice” interpreted. (NRS 630.130, 630.301)For the
purposes of NRS 630.301, as that
section existed before October 1, 1997, a physician shall be deemed to have
committed gross malpractice if, before October 1, 1997, the physician has
failed to exercise the required degree of care, skill or knowledge and such
failure amounts to:

1. A conscious indifference to the
consequences which may result from the malpractice; and

2. A disregard for and indifference to the
safety and welfare of a patient.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96;
A by R149-97, 3-30-98)

NAC 630.255Exemption from grounds: “Intractable pain” defined. (NRS 630.130, 630.135, 630.3066)For the
purposes of NRS 630.3066,
“intractable pain” means a condition of discomfort for which the cause cannot
be removed or otherwise treated and for which a method of providing relief, or
of which a cure for the cause, has not been found after reasonable efforts have
been taken in accordance with accepted standards for the practice of medicine,
including, but not limited to, evaluation by an attending physician and one or
more physicians specializing in the treatment of the area, system, or organ of
the body which is believed to be the source of the discomfort.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96)

NAC 630.260Notice of technical or scientific facts. (NRS 630.130)Parties
to a disciplinary hearing before the Board will be notified, either before or
during the hearing, of supposed technical or scientific facts of which the
Board may take notice, and the parties will be afforded an opportunity to
contest those facts. The Board’s experience, technical competence and
specialized knowledge may be utilized in the evaluation of evidence.

[Bd. of Medical Exam’rs, § 630.260, eff. 12-20-79]

NAC 630.270Disposition of findings and order of Board. (NRS 630.130, 630.269, 630.275)A copy
of the disciplinary findings and order of the Board:

1. Will be served by personal service or by
certified mail upon the person affected by them at the address of the person on
file with the Board and his or her attorney of record;

2. Will be delivered by first-class mail or
electronic mail to each hospital in the geographical area in which the
physician, physician assistant, perfusionist or practitioner of respiratory
care practices; and

3. May be delivered by first-class mail or
electronic mail to members of the media.

NAC 630.275Confidentiality of certain information regarding physicians, physician
assistants, practitioners of respiratory care and perfusionists. (NRS 630.130, 630.275, 630.269, 630.279, 630.336)The
Board will, pursuant to subsection 3 of NRS 630.336, keep confidential all
records relating to a program established by the Board to enable a physician,
physician assistant, practitioner of respiratory care or perfusionist to
correct:

1. A dependence upon alcohol or a controlled
substance; or

2. Any other impairment which could result
in the revocation of his or her license.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96;
A by R044-09, 11-25-2009, eff. 7-1-2010)

PHYSICIAN ASSISTANTS

NAC 630.280Qualifications of applicants. (NRS 630.130, 630.275)An
applicant for licensure as a physician assistant must have the following
qualifications:

1. If the applicant has not practiced as a
physician assistant for 12 months or more before applying for licensure in this
State, he or she must, at the order of the Board, have taken and passed the
same examination to test medical competency as that given to applicants for
initial licensure.

2. Be a citizen of the United States or be
lawfully entitled to remain and work in the United States.

3. Be able to communicate adequately orally
and in writing in the English language.

4. Be of good moral character and
reputation.

5. Have attended and completed a course of
training in residence as a physician assistant approved by one of the following
entities affiliated with the American Medical Association or its successor
organization:

(a) The Committee on Allied Health Education and
Accreditation or its successor organization;

(b) The Commission on Accreditation of Allied
Health Education Programs or its successor organization; or

(c) The Accreditation Review Committee on Education
for the Physician Assistant or its successor organization.

6. Be certified by the National Commission
on Certification of Physician Assistants or its successor organization.

7. Possess a high school diploma, general
equivalency diploma or postsecondary degree.

1. An application for licensure as a
physician assistant must be made on a form supplied by the Board. The
application must state:

(a) The date and place of the applicant’s birth and
his or her sex;

(b) The applicant’s education, including, without
limitation, high schools and postsecondary institutions attended, the length of
time in attendance at each and whether he or she is a graduate of those schools
and institutions;

(c) Whether the applicant has ever applied for a
license or certificate as a physician assistant in another state and, if so,
when and where and the results of his or her application;

(d) The applicant’s training and experience as a
physician assistant;

(e) Whether the applicant has ever been
investigated for misconduct as a physician assistant or had a license or
certificate as a physician assistant revoked, modified, limited or suspended or
whether any disciplinary action or proceedings have ever been instituted
against the applicant by a licensing body in any jurisdiction;

(f) Whether the applicant has ever been convicted
of a felony or an offense involving moral turpitude;

(g) Whether the applicant has ever been
investigated for, charged with or convicted of the use or illegal sale or
dispensing of controlled substances; and

(h) The various places of his or her residence from
the date of:

(1) Graduation from high school;

(2) Receipt of a high school general
equivalency diploma; or

(3) Receipt of a postsecondary degree,

Ê whichever
occurred most recently.

2. An applicant must submit to the Board:

(a) Proof of completion of an educational program
as a physician assistant:

(1) If the applicant completed the educational
program on or before December 31, 2001, which was approved by the Committee on
Allied Health Education and Accreditation or the Commission on Accreditation of
Allied Health Education Programs; or

(2) If the applicant completed the educational
program on or after January 1, 2002, which is accredited by the Accreditation
Review Commission on Education for the Physician Assistant or approved by the
Commission on Accreditation of Allied Health Education Programs;

(b) Proof of passage of the examination given by
the National Commission on Certification of Physician Assistants; and

(c) Such further evidence and other documents or
proof of qualifications as required by the Board.

3. Each application must be signed by the
applicant and sworn to before a notary public or other officer authorized to
administer oaths.

4. The application must be accompanied by
the applicable fee.

5. An applicant shall pay the reasonable
costs of any examination required for licensure.

NAC 630.315Denial of application. (NRS 630.130, 630.275)The
Board may deny an application for the issuance or renewal of a license to
practice as a physician assistant if the applicant has committed any of the
acts described in subsection 1 of NAC 630.380.

1. The Board will issue a temporary license
to any qualified applicant who:

(a) Meets the educational and training requirements
for certification as a physician assistant of the National Commission on
Certification of Physician Assistants and is scheduled to and does sit for the
first proficiency examination offered by the National Commission on
Certification of Physician Assistants following the completion of his or her
training;

(b) Has taken the proficiency examination offered
by the National Commission on Certification of Physician Assistants but has not
yet been notified of the results; or

(c) Is licensed or certified in another state,
meets the requirements for licensure pursuant to NAC
630.280 and is scheduled to sit for the next examination offered by the
Board.

2. A physician assistant with a temporary
license may perform services only under the immediate supervision of a
supervising physician.

NAC 630.325Locum tenens license. (NRS 630.130, 630.275)The
Board may issue a locum tenens license, which is effective for not more than 3
months after issuance, to any physician assistant who is licensed or certified
as a physician assistant and in good standing in another state and who is of
good moral character and reputation. The purpose of this license is to enable
an eligible physician assistant to serve as a substitute for another physician
assistant who is licensed to practice as a physician assistant in this State
and who is absent from his or her practice for reasons deemed sufficient by the
Board. A license issued pursuant to this section is not renewable.

(Added to NAC by Bd. of Medical Exam’rs, eff. 1-13-94;
A by R149-97, 3-30-98; R108-01, 11-29-2001)

2. Before providing medical services, a
physician assistant, on a form prescribed by the Board, shall notify the Board
of the name and location of the practice of the physician assistant, the name
of the supervising physician and the portion of the practice of the physician
assistant that the supervising physician supervises. The notice must contain
the signatures of the physician assistant and the supervising physician of the
physician assistant.

3. The physician assistant and the
supervising physician shall immediately notify the Board of the termination of
the supervision of the physician assistant by the supervising physician. For
any portion of the practice of the physician assistant that the supervising
physician terminating supervision of the physician assistant supervised, the
physician assistant shall not provide medical services until the physician
assistant and a supervising physician submit notice to the Board pursuant to
subsection 2.

4. A physician assistant who has been
licensed by the Board but is not currently licensed, has surrendered his or her
license or has failed to renew his or her license will be disciplined by the
Board, if the Board deems it necessary, upon hearing a complaint for
disciplinary action against the physician assistant.

5. If the Board determines that the conduct
of a physician assistant when he or she was on inactive status in another
jurisdiction would have resulted in the denial of an application for licensure
in this State, the Board will, if appropriate, refuse to license the physician
assistant.

1. The license of a physician assistant may
be renewed biennially. The license will not be renewed unless the physician
assistant provides satisfactory proof that the physician assistant has
completed the following number of hours of continuing medical education as
defined by the American Academy of Physician Assistants or has received a
certificate documenting the completion of the following number of hours of
Category 1 credits as recognized by the American Medical Association:

(a) If licensed during the first 6 months of the
biennial period of registration, 40 hours.

(b) If licensed during the second 6 months of the
biennial period of registration, 30 hours.

(c) If licensed during the third 6 months of the
biennial period of registration, 20 hours.

(d) If licensed during the fourth 6 months of the
biennial period of registration, 10 hours.

2. To allow for the renewal of a license to
practice as a physician assistant by each person to whom a license was issued
or renewed in the preceding renewal period, the Board will make such reasonable
attempts as are practicable to:

(a) Mail a renewal notice at least 60 days before
the expiration of a license to practice as a physician assistant; and

(b) Send a renewal application to a licensee at the
last known address of the licensee on record with the Board.

3. If a licensee fails to pay the fee for
biennial registration after it becomes due or fails to submit proof that the
licensee completed the number of hours of continuing medical education required
by subsection 1, his or her license to practice in this State expires. Within 2
years after the date on which the license expires, the holder may be reinstated
to practice as a physician assistant if the holder:

(a) Pays twice the amount of the current fee for biennial
registration to the Secretary-Treasurer of the Board;

(b) Submits proof that he or she completed the
number of hours of continuing medical education required by subsection 1; and

(c) Is found to be in good standing and qualified
pursuant to this chapter.

1. Pursuant to the provisions of NRS 630.253, a physician assistant
shall complete a course of instruction relating to the medical consequences of
an act of terrorism that involves the use of a weapon of mass destruction:

(a) If the physician assistant was initially
licensed by the Board on or after October 1, 2003, within 2 years of initial
licensure.

(b) If the physician assistant was initially
licensed by the Board before October 1, 2003, on or before September 30, 2005.

2. In addition to the requirements provided
pursuant to NRS 630.253, a
course of instruction relating to the medical consequences of an act of
terrorism that involves the use of a weapon of mass destruction:

(a) Except as otherwise provided in subsection 3,
must offer, upon successful completion of the program, a certificate of
Category 1 credit as recognized by the American Medical Association to the physician
assistant; and

(b) Is in addition to the continuing education
required pursuant to NAC 630.350.

3. A course of instruction relating to the
medical consequences of an act of terrorism that involves the use of a weapon
of mass destruction will be deemed to satisfy the requirements of paragraph (a)
of subsection 2 if the course was provided to a physician assistant:

1. Except as otherwise provided in
subsection 2, if a physician assistant takes a continuing education class on
geriatrics and gerontology, the physician assistant is entitled to receive
credit towards the continuing medical education required pursuant to NAC 630.350 equal to twice the number of hours the
physician assistant actually spends in a continuing education class on
geriatrics and gerontology.

2. During any biennial licensing period, a
physician assistant may receive a maximum credit pursuant to subsection 1 of 8
hours of continuing medical education for 4 hours of time spent in a continuing
education class on geriatrics and gerontology.

3. As used in this section, “continuing education
class on geriatrics and gerontology” means a class that meets the requirements
of:

1. The medical services which a physician
assistant is authorized to perform must be:

(a) Commensurate with the education, training,
experience and level of competence of the physician assistant; and

(b) Within the scope of the practice of the
supervising physician of the physician assistant.

2. The physician assistant shall wear at all
times while on duty a placard, plate or insigne which identifies him or her as
a physician assistant.

3. No physician assistant may represent
himself or herself in any manner which would tend to mislead the general public
or the patients of the supervising physician.

4. Except as otherwise provided in
subsection 3 of NAC 630.340, a physician assistant
shall notify the Board in writing within 72 hours after any change in the
supervision of the physician assistant by a supervising physician.

1. Except as otherwise provided in NAC 630.375, the supervising physician is responsible
for all the medical activities of his or her physician assistant and shall
ensure that:

(a) The physician assistant is clearly identified to
the patients as a physician assistant;

(b) The physician assistant performs only those
medical services which have been approved by his or her supervising physician;

(c) The physician assistant does not represent
himself or herself in any manner which would tend to mislead the general
public, the patients of the supervising physician or any other health
professional; and

(d) There is strict compliance with:

(1) The provisions of the certificate of
registration issued to his or her physician assistant by the State Board of
Pharmacy pursuant to NRS 639.1373;
and

(2) The regulations of the State Board of
Pharmacy regarding controlled substances, poisons, dangerous drugs or devices.

2. Except as otherwise required in
subsection 3 or 4, the supervising physician shall review and initial selected
charts of the patients of the physician assistant. Unless the physician
assistant is performing medical services pursuant to NAC
630.375, the supervising physician must be available at all times that his
or her physician assistant is performing medical services to consult with his
or her assistant. Those consultations may be indirect, including, without
limitation, by telephone.

3. At least once a month, the supervising
physician shall spend part of a day at any location where the physician
assistant provides medical services to act as a consultant to the physician
assistant and to monitor the quality of care provided by the physician
assistant.

4. Except as otherwise provided in this
subsection, if the supervising physician is unable to supervise the physician
assistant as required by this section, the supervising physician shall
designate a qualified substitute physician, who practices medicine in the same
specialty as the supervising physician, to supervise the assistant. If the
physician assistant is performing medical services pursuant to NAC 630.375, the supervising physician is not required
to comply with this subsection.

5. A physician who supervises a physician
assistant shall develop and carry out a program to ensure the quality of care
provided by a physician assistant. The program must include, without
limitation:

(a) An assessment of the medical competency of the
physician assistant;

(b) A review and initialing of selected charts;

(c) An assessment of a representative sample of the
referrals or consultations made by the physician assistant with other health
professionals as required by the condition of the patient;

(d) Direct observation of the ability of the
physician assistant to take a medical history from and perform an examination
of patients representative of those cared for by the physician assistant; and

(e) Maintenance by the supervising physician of
accurate records and documentation regarding the program for each physician
assistant supervised.

6. Except as otherwise provided in
subsection 7, a physician may supervise a physician assistant if the physician:

(a) Holds an active license in good standing to
practice medicine issued by the Board;

(b) Actually practices medicine in this State; and

(c) Has not been specifically prohibited by the
Board from acting as a supervising physician.

7. If the Board has disciplined a physician
assistant pursuant to NAC 630.410, a physician
shall not supervise that physician assistant unless the physician has been
specifically approved by the Board to act as the supervising physician of that
physician assistant.

3. When a physician assistant performs
medical services in a situation described in subsection 2:

(a) The physician assistant is not the agent of his
or her supervising physician and the supervising physician is not responsible
or liable for any medical services provided by the physician assistant.

(b) The physician assistant shall provide whatever
medical services are possible based on the need of the patient and the
training, education and experience of the physician assistant.

(c) If a licensed physician is available on-scene,
the physician assistant may take direction from the physician.

(d) The physician assistant shall make a reasonable
effort to contact his or her supervising physician, as soon as possible, to
advise him or her of the incident and the physician assistant’s role in
providing medical services.

(2) At the direction or under the supervision
of the supervising physician of the physician assistant;

(d) Has performed medical services which have not
been approved by the supervising physician of the physician assistant, unless
the medical services were performed pursuant to NAC
630.375;

(e) Is guilty of gross or repeated malpractice in
the performance of medical services for acts committed before October 1, 1997;

(f) Is guilty of malpractice in the performance of
medical services for acts committed on or after October 1, 1997;

(g) Is guilty of disobedience of any order of the
Board or an investigative committee of the Board, any provision in the
regulations of the State Board of Health or the State Board of Pharmacy or any
provision of this chapter;

(h) Is guilty of administering, dispensing or
possessing any controlled substance otherwise than in the course of legitimate
medical services or as authorized by law and the supervising physician of the
physician assistant;

(i) Has been convicted of a violation of any
federal or state law regulating the prescribing, possession, distribution or
use of a controlled substance;

(j) Is not competent to provide medical services;

(k) Failed to notify the Board of an involuntary
loss of certification by the National Commission on Certification of Physician
Assistants within 30 days after the involuntary loss of certification;

(n) Is guilty of violating a provision of
subsection 2 or 3 of NAC 630.340.

2. To institute disciplinary action against
a physician assistant, a written complaint, specifying the charges, must be
filed with the Board by the investigative committee of the Board.

3. A physician assistant is not subject to
disciplinary action solely for prescribing or administering to a patient under
the care of the physician assistant a controlled substance which is listed in
schedule II, III, IV or V by the State Board of Pharmacy pursuant to NRS 453.146.

NAC 630.390Disciplinary action: Notice of charges. (NRS 630.130, 630.275)Before
the Board takes disciplinary action against a physician assistant, the Board
will give to the physician assistant and to his or her supervising physician a
written notice specifying the charges made against the physician assistant and
stating that the charges will be heard at the time and place indicated in the
notice. The notice will be served on the physician assistant and the
supervising physician at least 20 days before the date fixed for the hearing.
Service of the notice will be made and any investigation and subsequent
disciplinary proceedings will be conducted in the same manner as provided by
law for disciplinary actions against physicians.

1. If the Board or any investigative
committee of the Board has reason to believe that the conduct of any physician
assistant has raised a reasonable question as to his or her competence to
practice as a physician assistant with reasonable skill and safety to patients,
it may order that the physician assistant undergo a mental or physical examination
or an examination testing his or her competence to practice as a physician
assistant by physicians or any other examination designated by the Board to
assist the Board or committee in determining the fitness of the physician
assistant to practice as a physician assistant.

2. Every physician assistant who applies for
or is issued a license and who accepts the privilege of performing medical
services in this State shall be deemed to have given his or her consent to
submit to such an examination pursuant to subsection 1 when the physician
assistant is directed to do so in writing by the Board.

3. For the purpose of this section, the
report of testimony or examination by the examining physicians does not
constitute a privileged communication.

4. Except in extraordinary circumstances, as
determined by the Board, the failure of a licensed physician assistant to
submit to an examination when he or she is directed to do so pursuant to this
section constitutes an admission of the charges against him or her. A default
and final order may be entered without the taking of testimony or presentation
of evidence.

5. A physician assistant who is subject to
an examination pursuant to this section shall pay the costs of the examination.

NAC 630.410Determination after notice and hearing: Sanctions or dismissal of
charges. (NRS
630.130, 630.275)If the
Board finds, by a preponderance of the evidence, after notice and hearing in
accordance with this chapter, that:

1. The charges in the complaint against the
physician assistant are true, the Board will issue and serve on the physician
assistant its written findings and any order of sanctions. The following
sanctions may be imposed by order:

(a) Placement on probation for a specified period
on any of the conditions specified in the order.

(b) Administration of a public reprimand.

(c) Limitation of his or her practice or exclusion
of one or more specified branches of medicine from his or her practice.

(d) Suspension of his or her license, for a specified
period or until further order of the Board.

(e) Revocation of his or her license to practice.

(f) A requirement that the physician assistant
participate in a program to correct alcohol or drug dependence or any other
impairment.

(g) A requirement that there be additional and
specified supervision of his or her practice.

(h) A requirement that the physician assistant
perform community service without compensation.

(i) A requirement that the physician assistant take
a physical or mental examination or an examination testing his or her medical
competence.

(j) A requirement that the physician assistant
fulfill certain training or educational requirements, or both, as specified by
the Board.

(k) A fine not to exceed $5,000.

(l) A requirement that the physician assistant pay
all costs incurred by the Board relating to the disciplinary proceedings.

2. No violation has occurred, it will issue
a written order dismissing the charges and notify the physician assistant that
the charges have been dismissed. If the disciplinary proceedings were initiated
as a result of a complaint filed against the physician assistant, the Board may
provide to the physician assistant a copy of the complaint and the name of the
person who filed the complaint.

1. The Board will appoint three licensed
physician assistants to an advisory committee. These physician assistants must
have lived in and actively and continuously practiced in this State as licensed
physician assistants for at least 3 years before their appointment.

2. The Board will give appointees to the
advisory committee written notice of their appointment and terms of office and
a written summary of any projects pending before the committee.

3. At the request of the Board, the advisory
committee shall review and make recommendations to the Board concerning any
matters relating to licensed physician assistants.

NAC 630.420Petition for amendment or repeal of regulation. (NRS 630.130)A
petition requesting the adoption, filing, amendment or repeal of any regulation
must be accompanied by a draft of the proposed regulation in a form suitable
for filing with the Secretary of State.

[Bd. of Medical Exam’rs, § 630.420, eff. 12-20-79]

NAC 630.430Filing of petition; copies. (NRS 630.130)The
petition must be filed with the Board. The original and 12 copies of the
petition must be filed, together with the original and 12 copies of the
proposed regulation.

1. Any petition filed more than 30 days
before the next regularly scheduled meeting of the Board will be considered by
the Board at that meeting. Any petition filed 30 days or less before the next
regularly scheduled meeting of the Board will be considered at the first
regular meeting scheduled more than 30 days after the petition is filed.

2. The Board will, within 30 days after
consideration of a petition, deny the petition in writing stating the reasons
for the denial or initiate proceedings under NRS 233B.060 for adoption of the
proposed regulation.

1. A petition for a declaratory order or
advisory opinion may be filed only by a holder of or applicant for a license.

2. The original and 12 copies of the
petition must be filed with the Board not less than 10 days before its next
regularly scheduled meeting. The petition must be submitted to the Board at
that meeting. Within 30 days thereafter, the Board will issue its declaratory
order or advisory opinion.

NAC 630.455Time limit for request to Board for consideration or action upon
matter at meeting. (NRS 630.130) Except
as otherwise provided in NAC 630.440 and 630.450, a request for the Board to consider or take
action upon a matter at a meeting must be received by the Board at least 15
business days before the date of the meeting.

1. Each party shall enter his or her
appearance at the beginning of a hearing or at a time designated by the
presiding officer by giving the party’s name and address and stating his or her
position or interest to the presiding officer. The information will be entered in
the record of the hearing.

2. Following the entry of an appearance by
an attorney for a party, all notices, pleadings and orders to be served on that
party must be served upon the attorney, and that service is valid for all
purposes upon the party represented.

3. All pleadings must be verified.

4. A party may respond to a complaint by
filing an answer within 20 working days after receiving the complaint. If a
party fails to file an answer within the time prescribed, he or she shall be
deemed to have denied generally the allegations of the complaint.

5. All motions, unless they are made during
a hearing, must be in writing. All written motions must set forth the nature of
relief sought, the grounds therefor and the points and authorities relied upon in
support of the motion. A party desiring to oppose a motion may serve and file a
written response to the motion within 10 working days after service of the
motion. The moving party may serve and file a written reply within 5 working
days after service of the opposition to the motion. All motions made during a
hearing must be based upon matters arising during the hearing. A decision on
the motion will be rendered without oral argument unless oral argument is
ordered by the Board, a panel of members of the Board or the hearing officer in
which event the Board, panel or hearing officer will set a date and time for
hearing.

6. The original and two copies of each
pleading, motion or other paper must be filed with the Board. A copy of each
pleading or motion must be made available by the party filing it to any other
person whom the Board determines may be affected by the proceeding and who
desires the copy.

7. Any document required to be served by a
party, other than a notice of hearing, complaint, adverse decision, or order of
the Board, may be served by mail, and the service shall be deemed complete when
a true copy of the document, properly addressed and stamped, is deposited in
the United States mail.

8. There must appear on, or be attached to,
each document required to be served:

(a) Proof of service by a certificate of an
attorney or his or her employee;

1. At least 30 days before a hearing but not
earlier than 30 days after the date of service upon the physician or physician
assistant of a formal complaint that has been filed with the Board pursuant to NRS 630.311, unless a different
time is agreed to by the parties, the presiding member of the Board or panel of
members of the Board or the hearing officer shall conduct a prehearing
conference with the parties and their attorneys. All documents presented at the
prehearing conference are not evidence, are not part of the record and may not
be filed with the Board.

2. Each party shall provide to every other
party a copy of the list of proposed witnesses and their qualifications and a
summary of the testimony of each proposed witness. A witness whose name does
not appear on the list of proposed witnesses may not testify at the hearing
unless good cause is shown.

3. All evidence, except rebuttal evidence,
which is not provided to each party at the prehearing conference may not be
introduced or admitted at the hearing unless good cause is shown.

4. Each party shall submit to the presiding
member of the Board or panel or to the hearing officer conducting the
conference each issue which has been resolved by negotiation or stipulation and
an estimate, to the nearest hour, of the time required for presentation of its
oral argument.

1. The President of the Board shall
determine whether a hearing will be held before the Board, a hearing officer or
a panel of members of the Board. Any hearing before the Board must be held
before a majority of the members of the Board.

2. If a licensee fails to appear at a
scheduled hearing and no continuance has been requested and granted, the
evidence may be heard and the matter may be considered and disposed of on the
basis of the evidence before the Board, panel or hearing officer in the manner
required by this section.

3. The presiding member of the Board or panel,
or the hearing officer will call the hearing to order and proceed to take the
appearances on behalf of the Board, panel or hearing officer and the licensee,
any other party and their counsel. The Board, panel or hearing officer will act
upon any pending motions, stipulations and preliminary matters. The notice of
hearing, complaint, petition, answer, response or written stipulation becomes a
part of the record without being read unless a party requests that the document
be read verbatim into the record. The Board will present its evidence first and
then the licensee will submit his or her evidence. Closing statements by the
parties may be allowed by the Board, panel or hearing officer.

4. Prehearing depositions of witnesses and
parties may not be taken and no formal discovery of evidence, except as
otherwise provided in NAC 630.465, will be allowed.

5. The Board, panel or hearing officer will
hear the evidence presented, make appropriate rulings on the admissibility of
evidence, and maintain procedure and order during the hearing. The Board, panel
or hearing officer may not dismiss the complaint.

6. The presiding member of the Board or
panel or the hearing officer may, upon his or her motion or the motion of a
party, order a witness, other than the licensee, to be excluded from the
hearing to prevent that witness from hearing the testimony of another witness
at the hearing.

7. Briefs must be filed upon the order of
the Board, panel or hearing officer. The time for filing briefs will be set by
the Board, panel or hearing officer.

8. The hearing officer or panel of members
of the Board conducting a hearing shall:

(a) Submit to the Board a synopsis of the testimony
taken at the hearing; and

(b) Make a recommendation to the Board on the
veracity of witnesses if there is conflicting evidence or the credibility of
witnesses is a determining factor.

9. A case shall be deemed submitted for
decision by the Board after the taking of evidence, the filing of briefs or the
presentation of such oral arguments as may have been permitted, the filing of
the transcript of the hearing and the filing of the synopsis of the testimony
taken at the hearing. The Board will issue its order or render its decision
within 90 days after the hearing or the submission of the case, whichever is
later.

1. A subpoena issued pursuant to NRS 630.140 must specify the name
of the witness and specifically identify the books, X rays, medical records or
other papers which are required to be produced.

2. The Board or a person acting on its
behalf will not issue a subpoena to compel the attendance of a member of the
Board or a licensee at a hearing or require a member of the Board or a licensee
to produce books, X rays, medical records or any other papers during a hearing.

3. The Board or a person acting on its
behalf will not petition the district court for an order compelling compliance
with a subpoena unless:

(a) At the time the subpoena is served, the witness
is tendered:

(1) A fee of $25 for the first day of
attendance at the hearing;

(2) An allowance for travel which is equal to
the allowance for travel by private conveyance provided for state officers and
employees generally; and

(3) A per diem allowance equal to the per diem
allowance provided for state officers and employees generally.

(b) It is served upon the witness at least 120
hours before he or she is required to appear at the hearing.

(Added to NAC by Bd. of Medical Exam’rs, eff. 1-13-94;
A by R149-97, 3-30-98)

1. Except as otherwise provided in this
section, a physician may collaborate with an advanced practice registered nurse
if the physician:

(a) Holds an active license in good standing to
practice medicine;

(b) Actually practices medicine in this State; and

(c) Has not been specifically prohibited by the
Board from acting as a collaborating physician.

2. No physician may collaborate with an
advanced practice registered nurse whose scope of practice or medical
competence is other than the scope of practice or medical competence of the
physician.

3. Before collaborating with an advanced
practice registered nurse, a physician, on a form prescribed by the Board,
shall notify the Board of the name and location of the practice of the advanced
practice registered nurse and the portion of the practice of the advanced
practice registered nurse that the physician will collaborate on with the
advanced practice registered nurse. The notice must contain the signatures of
the advanced practice registered nurse and the collaborating physician.

4. In addition to any other requirements, if
the State Board of Nursing pursuant to NRS 632.325 has disciplined an
advanced practice registered nurse, a physician shall not collaborate with that
advanced practice registered nurse unless the physician has been specifically
approved by the Board to act as the collaborating physician of that advanced
practice registered nurse.

5. A collaborating physician shall
immediately notify the Board of the termination of collaboration between the
collaborating physician and an advanced practice registered nurse. For any
portion of the practice of the advanced practice registered nurse that the
collaborating physician terminating collaboration with the advanced practice
registered nurse collaborated, no physician shall collaborate with the advanced
practice registered nurse until the physician submits notice to the Board
pursuant to subsection 3.

6. The collaborating physician or his or her
substitute shall be available at all times that the advanced practice
registered nurse is providing medical services to consult with the advanced
practice registered nurse. Those consultations may be indirect, including,
without limitation, by telephone.

7. The collaborating physician shall, at
least once a month, spend part of a day at any location where the advanced
practice registered nurse provides medical services to act as consultant to the
advanced practice registered nurse and to monitor the quality of care provided
by an advanced practice registered nurse.

8. The collaborating physician shall develop
and carry out a program to ensure the quality of care provided by an advanced
practice registered nurse. The program must include, without limitation:

(a) An assessment of the medical competency of the
advanced practice registered nurse;

(b) A review and initialing of selected charts;

(c) An assessment of a representative sample of referrals
or consultations made by the advanced practice registered nurse with another
health professional as required by the condition of the patient;

(d) Direct observation of the ability of the
advanced practice registered nurse to take a medical history from and perform
an examination of patients representative of those cared for by the advanced
practice registered nurse; and

(e) Maintenance of accurate records and
documentation of the program for each advanced practice registered nurse with
whom the physician collaborated.

(b) Practices in strict compliance with the
regulations of the State Board of Pharmacy regarding prescriptions, controlled
substances, dangerous drugs and devices.

10. The medical director of a practice that
is specific to a site, including, without limitation, a facility for skilled
nursing or a hospital, may act as a collaborating physician to an advanced
practice registered nurse who works at the practice. A medical director acting
as a collaborating physician may allow the advanced practice registered nurse
to evaluate and care for patients under the direction of an attending physician
who is not the collaborating physician of the advanced practice registered
nurse.

11. A collaborating physician shall ensure
that the medical services that an advanced practice registered nurse performs
while collaborating with the physician are:

(a) Commensurate with the education, training,
experience and level of competence of the advanced practice registered nurse;
and

(b) Within the scope of practice of the:

(1) Advanced practice registered nurse;

(2) Certification of the advanced practice
registered nurse; and

(3) Collaborating physician.

12. If the collaborating physician is unable
to act as the collaborating physician for an advanced practice registered
nurse, he or she shall designate a qualified substitute physician to act as a
temporary collaborating physician. The scope of practice or medical competence
of the temporary collaborating physician must be the same as the scope of
practice or medical competence of the original collaborating physician.

13. The collaborating physician is
responsible for all the medical services performed by the advanced practice
registered nurse.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86;
A by R149-97, 3-30-98; R145-03, 12-16-2003)

1. Except as otherwise provided in
subsection 2, a physician shall not simultaneously:

(a) Supervise more than three physician assistants;

(b) Collaborate with more than three advanced
practice registered nurses; or

(c) Supervise or collaborate with a combination of
more than three physician assistants and advanced practice registered nurses.

2. A physician may petition the Board for
approval to supervise or collaborate with more physician assistants and
advanced practice registered nurses than he or she would otherwise be allowed
pursuant to subsection 1. The Board will not approve the petition unless the physician
provides satisfactory proof to the Board that:

(a) Special circumstances regarding his or her
practice exist that necessitate his or her supervision or collaboration with
more physician assistants and advanced practice registered nurses than would
otherwise be allowed pursuant to subsection 1; and

(b) The physician will be able to supervise or
collaborate with the number of physician assistants and advanced practice
registered nurses for which he or she is requesting approval in a satisfactory
manner.

(Added to NAC by Bd. of Medical Exam’rs by R149-97,
eff. 3-30-98; A by R108-01, 11-29-2001)

PRACTITIONERS OF RESPIRATORY CARE

NAC 630.500Qualifications of applicants. (NRS 630.130, 630.279)An
applicant for licensure as a practitioner of respiratory care must have the
following qualifications:

1. If he or she has not practiced as a
practitioner of respiratory care for 12 months or more immediately preceding
his or her application for licensure in this State, the applicant must, except
as otherwise provided in subsections 2 and 3, at the order of the Board, take
and pass any examination that the Board deems appropriate to test the
professional competency of the practitioner.

2. If he or she has not practiced as a
practitioner of respiratory care for 12 months or more but less than 5 years
immediately preceding his or her application for licensure in this State, the applicant
may provide proof that he or she has successfully completed 10 units of
continuing education for each year or portion thereof he or she has not
practiced respiratory care. If he or she provides proof of successfully
completing at least 10 units of continuing education for each year or portion
thereof he or she has not practiced respiratory care, the applicant is exempt
from the examination required pursuant to subsection 1.

3. If he or she has not practiced as a
practitioner of respiratory care for 5 years or more immediately preceding his
or her application for licensure in this State, the applicant must retake and
pass the examination required to be certified as a practitioner of respiratory
care administered by the National Board for Respiratory Care or its successor
organization.

4. Be a citizen of the United States or be
lawfully entitled to remain and work in the United States.

5. Be able to communicate adequately orally
and in writing in the English language.

1. An application for licensure as a
practitioner of respiratory care must be made on a form supplied by the Board.
The application must include:

(a) The date of birth and the birthplace of the
applicant, his or her sex and the various places of his or her residence after
reaching 18 years of age;

(b) The education of the applicant, including,
without limitation, all high schools, postsecondary institutions and
professional institutions attended, the length of time in attendance at each
high school or institution and whether he or she is a graduate of those schools
and institutions;

(c) Whether the applicant has ever applied for a
license or certificate as a practitioner of respiratory care in another state
and, if so, when and where and the results of his or her application;

(d) The professional training and experience of the
applicant;

(e) Whether the applicant has ever been
investigated for misconduct as a practitioner of respiratory care or had a
license or certificate as a practitioner of respiratory care revoked, modified,
limited or suspended or whether any disciplinary action or proceedings have
ever been instituted against him or her by a licensing body in any
jurisdiction;

(f) Whether the applicant has ever been convicted
of a felony or an offense involving moral turpitude;

(g) Whether the applicant has ever been
investigated for, charged with or convicted of the use, illegal sale or
distribution of controlled substances; and

(h) A public address where the applicant may be
contacted by the Board.

2. An applicant must submit to the Board:

(a) Proof of completion of an educational program
as a practitioner of respiratory care that is approved by the Commission on
Accreditation of Allied Health Education Programs or its successor organization
or the Committee on Accreditation for Respiratory Care or its successor
organization;

1. On or before July 1 of each odd-numbered
year after March 1, 2010, each holder of a license to practice respiratory care
shall pay the applicable fee for biennial registration to the Secretary-Treasurer
of the Board.

2. A practitioner of respiratory care who
has been licensed by the Board but is not currently licensed, has surrendered
his or her license or has failed to renew his or her license may be disciplined
by the Board, if the Board deems necessary, upon hearing a complaint for
disciplinary action against him or her.

3. If the Board determines that the conduct
of a practitioner of respiratory care when he or she was on inactive status in
another jurisdiction would have resulted in the denial of an application for
licensure in this State, the Board will, if appropriate, refuse to license the
practitioner of respiratory care.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001; A by R124-10, 12-16-2010)

1. The license of a practitioner of
respiratory care may be renewed biennially upon dates set by the Board. The
license will not be renewed unless the practitioner of respiratory care
provides satisfactory proof:

(a) Of current certification by the National Board
for Respiratory Care or its successor organization; and

(b) That he or she has completed the number of
contact hours of continuing professional education required by subsections 2
and 3.

2. To renew a license for the practice of
respiratory care, a licensee must complete the number of contact hours of
continuing education required by subsection 3, of which:

(a) Sixty percent must be from an approved
educational source directly related to the practice of respiratory care. Two
hours of this 60 percent must be in medical ethics.

(b) Forty percent must be in any program approved
by the American Association for Respiratory Care for Continuing Respiratory
Care Education or any program of another organization approved by the Board.

3. The following contact hours for
continuing education are required for a licensee to renew a license for the
practice of respiratory care:

(a) If licensed during the first 6 months of the
biennial period of registration, 20 hours.

(b) If licensed during the second 6 months of the
biennial period of registration, 15 hours.

(c) If licensed during the third 6 months of the
biennial period of registration, 10 hours.

(d) If licensed during the fourth 6 months of the
biennial period of registration, 5 hours.

4. A practitioner of respiratory care shall
notify the Board within 10 days if his or her certification by the National
Board for Respiratory Care or its successor organization is withdrawn.

5. To allow for the renewal of a license to
practice respiratory care by each person to whom a license was issued or
renewed in the preceding renewal period, the Board will make such reasonable
attempts as are practicable to:

(a) Mail a renewal notice at least 60 days before
the expiration of a license to practice respiratory care; and

(b) Send a renewal application to a licensee at the
last known address of the licensee on record with the Board.

6. If a licensee fails to pay the fee for
biennial registration required by NAC 630.525 on or
before July 1 of each odd-numbered year, or fails to submit proof that the
licensee completed the number of contact hours of continuing education required
by subsections 2 and 3, his or her license to practice respiratory therapy in
this State expires. Within 2 years after the date on which the license expires,
the holder may be reinstated to practice respiratory care if he or she:

(a) Pays twice the amount of the current fee for
biennial registration to the Secretary-Treasurer of the Board;

(b) Submits proof that he or she completed the
number of contact hours of continuing education required by subsections 2 and
3; and

(c) Is found to be in good standing and qualified
pursuant to the provisions of this chapter and NRS 630.277.

7. The Board may issue not more than 10
contact hours of continuing education during a biennial licensing period to a
licensee if the licensee performs a medical review for the Board. The hours
issued by the Board:

(a) May be credited against the hours required for
a biennial licensing period pursuant to subsections 2 and 3; and

(b) Must be equal to the actual time involved in
performing the medical review, not to exceed 10 hours.

NAC 630.535Suspension upon loss of certification. (NRS 630.130, 630.279)If a
licensee loses certification by the National Board for Respiratory Care or its
successor organization, his or her license to practice respiratory care is
automatically suspended until further order of the Board.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.540Grounds for discipline or denial of licensure. (NRS 630.130, 630.279)A
practitioner of respiratory care is subject to discipline or denial of
licensure by the Board if, after notice and hearing in accordance with this
chapter, the Board finds that the practitioner of respiratory care:

1. Willfully and intentionally made a false
or fraudulent statement or submitted a forged or false document in applying for
a license or renewing a license.

2. Performed respiratory care services other
than as permitted by law.

3. Committed malpractice in the performance
of respiratory care services, which may be evidenced by claims settled against
a practitioner of respiratory care.

4. Disobeyed any order of the Board or an
investigative committee of the Board or violated a provision of this chapter.

5. Is not competent to provide respiratory
care services.

6. Lost his or her certification by the
National Board for Respiratory Care or its successor organization.

7. Failed to notify the Board of loss of
certification by the National Board for Respiratory Care or its successor
organization.

8. Falsified records of health care.

9. Rendered respiratory care to a patient
while under the influence of alcohol or any controlled substance or in any
impaired mental or physical condition.

10. Practiced respiratory care after his or
her license has expired or been suspended.

11. Has been convicted of a felony, any
offense involving moral turpitude or any offense relating to the practice of
respiratory care or the ability to practice respiratory care.

12. Has had a license to practice
respiratory care revoked, suspended, modified or limited by any other
jurisdiction or has surrendered such license or discontinued the practice of respiratory
care while under investigation by any licensing authority, a medical facility,
a branch of the Armed Forces of the United States, an insurance company, an
agency of the Federal Government or any employer.

13. Engaged in any sexual activity with a
patient who is currently being treated by the practitioner of respiratory care.

14. Engaged in disruptive behavior with
physicians, hospital personnel, patients, members of the family of a patient or
any other person if the behavior interferes with patient care or has an adverse
impact on the quality of care rendered to a patient.

15. Engaged in conduct that violates the
trust of a patient and exploits the relationship between the practitioner of
respiratory care and the patient for financial or other personal gain.

16. Engaged in conduct which brings the
respiratory care profession into disrepute, including, without limitation,
conduct which violates any provision of a national code of ethics adopted by
the Board by regulation.

17. Engaged in sexual contact with a
surrogate of a patient or other key person related to a patient, including,
without limitation, a spouse, parent or legal guardian, that exploits the
relationship between the practitioner of respiratory care and the patient in a
sexual manner.

18. Made or filed a report that the
practitioner of respiratory care knows to be false, failed to file a record or
report as required by law or willfully obstructed or induced another to
obstruct such filing.

19. Altered the medical records of a
patient.

20. Failed to report any person that the
practitioner of respiratory care knows, or has reason to know, is in violation
of the provisions of chapter 630 of
NRS or NAC 630.500 to 630.560,
inclusive, relating to the practice of respiratory care.

21. Has been convicted of a violation of any
federal or state law regulating the prescription, possession, distribution or
use of a controlled substance.

22. Held himself or herself out or permitted
another to represent him or her as a licensed physician.

23. Violated any provision that would
subject a practitioner of medicine to discipline pursuant to NRS 630.301 to 630.3065, inclusive, or NAC 630.230.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.545Disciplinary action: Notice of charges. (NRS 630.130, 630.279)Before
the Board takes disciplinary action against a practitioner of respiratory care,
the Board will give to the practitioner of respiratory care a written notice
specifying the charges made against the practitioner of respiratory care and
stating that the charges will be heard at the time and place indicated in the
notice. The notice will be served on the practitioner of respiratory care at
least 20 days before the date fixed for the hearing. Service of the notice will
be made, and any investigation and subsequent proceedings will be conducted in
the same manner as provided by law for disciplinary actions against physicians.

1. If the Board or any investigative
committee of the Board has reason to believe that the conduct of any
practitioner of respiratory care has raised a reasonable question as to his or
her competence to practice as a practitioner of respiratory care with
reasonable skill and safety to patients, the Board may order that the
practitioner of respiratory care undergo a mental or physical examination or an
examination testing his or her competence to practice as a practitioner of
respiratory care administered by physicians or practitioners of respiratory
care or any other examination designated by the Board to assist the Board or
committee in determining the fitness of the practitioner of respiratory care to
practice as a practitioner of respiratory care.

2. Every practitioner of respiratory care
who applies for or is issued a license and who accepts the privilege of
performing respiratory care in this State shall be deemed to have given his or
her consent to submit to such an examination pursuant to subsection 1 if he or
she is directed to do so in writing by the Board.

3. For the purpose of this section, a report
of the testimony or an examination by an examining physician or practitioner of
respiratory care does not constitute a privileged communication.

4. Except in extraordinary circumstances, as
determined by the Board, the failure of a licensed practitioner of respiratory
care to submit to an examination if he or she is directed to do so pursuant to
this section constitutes an admission of the charges against him or her. A
default and final order may be entered without the taking of testimony or
presentation of evidence.

5. A practitioner of respiratory care who is
subject to an examination pursuant to this section shall pay the costs of the
examination.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.555Determination after notice and hearing: Sanctions or dismissal of
charges. (NRS
630.130, 630.279)If the
Board finds, by a preponderance of the evidence, after notice and hearing in
accordance with this chapter, that:

1. The charges in a complaint against a
practitioner of respiratory care are true, the Board will issue and serve on
the practitioner of respiratory care its written findings and any order of
sanctions. The following sanctions may be imposed on a practitioner of
respiratory care by order of the Board:

(a) Placement on probation for a specified period
on any of the conditions specified in the order.

(b) Administration of a public reprimand.

(c) Suspension of his or her license for a
specified period or until further order of the Board.

(d) Revocation of his or her license to practice.

(e) A requirement that he or she participate in a
program to correct alcohol or drug dependence or any other impairment.

(f) A requirement that there be specified
supervision of his or her practice.

(g) A requirement that he or she perform public
service without compensation.

(h) A requirement that he or she take a physical or
mental examination or an examination testing his or her medical competence.

(i) A requirement that he or she fulfill certain
training or educational requirements, or both, as specified by the Board.

(j) A fine not to exceed $1,500.

(k) A requirement that the practitioner of
respiratory care pay all costs incurred by the Board relating to the
disciplinary proceedings.

2. No violation has occurred, the Board will
issue a written order dismissing the charges and notify the practitioner of
respiratory care that the charges have been dismissed. If the disciplinary
proceedings were initiated as a result of a complaint filed against the
practitioner of respiratory care, the Board may provide to the practitioner of
respiratory care a copy of the complaint and the name of the person who filed
the complaint.

1. The Board will appoint five licensed
practitioners of respiratory care to an advisory committee. These practitioners
of respiratory care must have lived in and actively and continuously practiced
in this State as practitioners of respiratory care for at least 3 years before
their appointment.

2. The Board will give appointees to the
advisory committee written notice of their appointment and terms of office and
a written summary of any projects pending before the committee.

3. At the request of the Board, the advisory
committee shall review and make recommendations to the Board concerning any
matters relating to licensed practitioners of respiratory care.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001; A by R081-05, 10-31-2005)

USE OF MEANS OR INSTRUMENTALITIES OF TREATMENT OTHER THAN
CONVENTIONAL TREATMENT

2. Based upon medical training, experience
and peer-reviewed scientific literature; and

3. Ordinarily utilized by physicians in good
standing practicing in the same specialty or field.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.605Provisional approval; disciplinary action for violation. (NRS 630.130)Except
as otherwise provided in NAC 630.610 to 630.630, inclusive, a licensee may practice medicine
by utilizing any means or instrumentality. A licensee is subject to
disciplinary action by the Board if the Board finds that the licensee has violated
any of the provisions of NAC 630.610 to 630.630, inclusive.

1. Has a risk for a patient which is
unreasonably greater than the means or instrumentality ordinarily utilized by
physicians in good standing practicing in the same specialty or field; or

2. Is provided as a substitute for any
conventional treatment which has proven to be of substantial benefit to the
patient.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.615Assessment of patient; contents of assessment. (NRS 630.130)Before
offering advice about the means or instrumentality of treatment, the licensee
shall undertake an assessment of the patient. The assessment must be documented
in the medical chart of the patient and should include, without limitation, the
conventional methods of diagnosis ordinarily utilized by physicians in good
standing practicing in the same specialty or field. The assessment may include
nonconventional methods of diagnosis. The assessment must include the
following:

1. An adequate medical record.

2. Documentation as to whether conventional
treatment options, including, without limitation, referral options for
conventional treatment, ordinarily utilized by physicians in good standing
practicing in the same specialty or field have been:

(a) Discussed with the patient;

(b) Offered to the patient;

(c) Refused by the patient; or

(d) Undertaken with the patient and, if so, the
outcome of the treatment.

3. If a treatment is offered which is not
considered to be conventional, documentation of written informed consent by the
patient for each treatment plan, including, without limitation, documentation
that the risks and benefits of the use of both the conventional and the other
means or instrumentality of treatment were discussed with the patient or
guardian.

4. A review of the current diagnosis and
conventional treatment.

5. Documentation as to whether the other
means or instrumentality of treatment could interfere with any other ongoing
conventional treatment.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.620Documented treatment plan. (NRS 630.130)The
licensee may offer the patient any means or instrumentality of treatment other
than conventional treatment if it is offered pursuant to a documented treatment
plan tailored for the individual needs of the patient. The documented treatment
plan must:

2. Consider pertinent medical history,
previous medical records and physical examinations, and the need for further
testing, consultations, referrals or the use of other treatment modalities.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.625Periodic reviews of care of patient. (NRS 630.130)To
utilize means or instrumentalities of treatment other than conventional
treatment, the licensee must document and conduct periodic reviews of the care
of the patient. The periodic reviews must:

1. Consider the individual circumstances of
the patient;

2. Be conducted at reasonable intervals in
consideration of the individual circumstances of the patient;

3. Report the progress in reaching treatment
objectives; and

4. Take into consideration the treatment
prescribed, ordered or administered, as well as any new information about the
etiology of the complaint.

(Added to NAC by Bd. of Medical Exam’rs by R108-01,
eff. 11-29-2001)

NAC 630.630Records of care provided to patient. (NRS 630.130)The
licensee shall maintain complete and accurate records of the care provided to
the patient, including, without limitation, the requirements of NAC 630.610 to 630.625,
inclusive.

1. An application for licensure as a
perfusionist must be made on a form provided by the Board. The application must
set forth:

(a) The date and place of birth of the applicant;

(b) The gender of the applicant;

(c) The education of the applicant, including,
without limitation, each high school and postsecondary institution attended by
the applicant, the dates of attendance and whether the applicant is a graduate
of those schools and institutions;

(d) If the applicant has ever applied for a license
or certificate to practice perfusion in another state or jurisdiction, the date
and disposition of the application;

(e) The training and experience of the applicant in
the practice of perfusion;

(f) If the applicant has ever been investigated for
misconduct in the practice of perfusion, had a license or certificate to
practice perfusion revoked, modified, limited or suspended or had any
disciplinary action or proceeding instituted against the applicant by a
licensing body in another state or jurisdiction, the dates, circumstances and
disposition of each such occurrence;

(g) If the applicant has ever been convicted of a
felony or any offense involving moral turpitude, the dates, circumstances and
disposition of each such occurrence;

(h) If the applicant has ever been investigated
for, charged with or convicted of the use or illegal sale or dispensing of a
controlled substance, the dates, circumstances and disposition of each such
occurrence; and

(i) Each place of residence of the applicant after
the date of graduation of the applicant from high school or the receipt by the
applicant of a high school general equivalency diploma, whichever occurred most
recently.

2. An applicant must submit to the Board:

(a) Proof that the applicant is a citizen of the
United States or that the applicant is lawfully entitled to remain and work in
the United States.

(b) Proof of completion of a perfusion education
program that satisfies the requirements of NRS 630.2691. For the purpose of
that section, the following perfusion education programs shall be deemed
approved by the Board:

(1) Any perfusion education program completed
by the applicant on or before June 1, 1994, which was approved by the Committee
on Allied Health Education and Accreditation of the American Medical
Association;

(2) Any perfusion education program completed
by the applicant after June 1, 1994, which was accredited by the Accreditation
Committee-Perfusion Education and approved by the Commission on Accreditation
of Allied Health Education Programs of the American Medical Association, or its
successor; or

(3) Any other perfusion education program
completed by the applicant, the educational standards of which the Board
determines are at least as stringent as those established by the Accreditation
Committee-Perfusion Education and approved by the Commission on Accreditation
of Allied Health Education Programs of the American Medical Association, or its
successor.

(c) Except as otherwise provided in NRS 630.2693, proof of passage of
the certification examination given by the American Board of Cardiovascular
Perfusion or its successor, as required by NRS 630.2692.

(d) Such further evidence and other documents or
proof of qualifications as are required by the Board.

3. Each application must be signed by the
applicant and sworn to before a notary public or other officer authorized to
administer oaths.

4. The application must be accompanied by
the applicable fee.

5. An applicant shall pay the reasonable
costs of any examination required for licensure.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff.
12-16-2010; A by R093-12, 2-20-2013; R036-13, 2-26-2014)

NAC 630.710Grounds for rejection of application. (NRS 630.130, 630.269)The
Board may reject an application for licensure as a perfusionist if the Board
determines that:

1. The applicant is not qualified or is not
of good moral character or reputation;

2. Any credential submitted by the applicant
is false; or

3. The application is not made in proper
form or is otherwise deficient.

2. The duration of the license, as
determined pursuant to NRS 630.2695;
and

3. Any limitation or requirement applicable
to the license that is prescribed by the Board.

(Added to NAC by Bd. of Medical Exam’rs by R079-10,
eff. 12-16-2010)

NAC 630.730Primary location of practice. (NRS 630.130, 630.269)Before
providing perfusion services, a perfusionist must notify the Board, on a form
prescribed by the Board, of the name and location of the primary location of
practice of the perfusionist. The form must be signed by the perfusionist.

1. The license of a perfusionist may be
renewed biennially. Except as otherwise provided in subsection 2, each person
licensed as a perfusionist shall, at the time of the renewal of his or her
license, provide satisfactory proof to the Board that he or she has completed
during the biennial licensing period at least 30 hours of continuing education
units that have been approved for credit by the American Board of
Cardiovascular Perfusion. The continuing education units must be completed in
the various categories of continuing education recognized by the American Board
of Cardiovascular Perfusion, as follows:

(a) At least 15 hours, not less than 2 hours of
which must be related to medical ethics, must be completed in Category I
approved continuing education, which may include, without limitation, such
activities as:

(1) Attendance at an international, national,
regional or state meeting relating to perfusion.

(2) Publication of a book, chapter or article
relating to perfusion.

(3) Presenting or addressing at an
international, national, regional or state meeting relating to perfusion.

(b) Not more than 15 hours may be completed in
Category II or Category III approved continuing education, which may include,
without limitation, such activities as:

(1) Attendance at an international, national,
regional, state or local meeting relating to perfusion that has not been
approved for Category I credit.

(2) Attendance at a manufacturer-specific or
company-sponsored educational activity that was not equally accessible to all
perfusionists.

(3) Attendance at a medically-related
international, national, regional, state or local meeting that has not been
approved for Category I credit.

(4) Attendance at advanced cardiac
life-support training that has not been approved for Category I credit.

(5) Individual education and other self-study
activities that have not been approved for Category I credit.

2. If the perfusionist was licensed only
during the second year of a biennial licensing period, he or she must attain
and prove upon his or her renewal application the completion during the
biennial licensing period of at least 16 hours of continuing education units
that have been approved for credit by the American Board of Cardiovascular
Perfusion, as follows:

(a) At least 8 hours, not less than 2 hours of
which must be related to medical ethics, must be completed in Category I
approved continuing education activities; and

(b) Not more than 8 hours must be completed in
Category II and Category III approved continuing education activities.

3. The notice of renewal that the Board is
required to send to a licensed perfusionist pursuant to NRS 630.2695 will be sent to the
last known address of the perfusionist on record with the Board.

4. The Board may issue not more than 15
hours of continuing education units during a biennial licensing period to a
licensed perfusionist if the perfusionist performs a medical review for the
Board. The hours issued by the Board:

(a) May be credited against the hours required for
a biennial licensing period pursuant to subsection 1 or 2; and

(b) Must be equal to the actual time involved in
performing the medical review, not to exceed 15 hours.

(Added to NAC by Bd. of Medical Exam’rs by R079-10,
eff. 12-16-2010; A by R035-13, 2-26-2014)

NAC 630.750Fee for reinstatement of expired license. (NRS 630.130, 630.269)The fee
for the reinstatement of an expired license pursuant to NRS 630.2695 is an amount equal to
twice the current amount of the fee for the biennial renewal of the license.

1. The services that a perfusionist may be
authorized to perform under the order and supervision of a physician must be
commensurate with the education, training, experience and level of competence
of the perfusionist.

2. A perfusionist shall at all times while
on duty wear a placard, plate or insigne which identifies himself or herself as
a perfusionist.

3. A perfusionist shall not represent
himself or herself in any manner that would tend to mislead a patient or the
general public.

1. A perfusionist is subject to discipline
pursuant to chapter 630 of NRS or
denial of licensure by the Board if, after notice and hearing, the Board finds
that the perfusionist:

(a) Willfully and intentionally made a false or
fraudulent statement or submitted a forged or false document in applying for or
renewing a license.

(b) Performed perfusion services other than as
permitted by law.

(c) Committed malpractice in the performance of
perfusion services, which may be evidenced by claims settled against the
perfusionist.

(d) Disobeyed any order of the Board or an
investigative committee of the Board or violated any provision of this chapter
or chapter 630 of NRS.

(e) Is not competent to provide perfusion services.

(f) Lost his or her certification by the American
Board of Cardiovascular Perfusion or its successor organization.

(g) Failed to notify the Board of loss of
certification by the American Board of Cardiovascular Perfusion or its
successor organization within 30 days after the loss of certification.

(h) Falsified or altered records of health care.

(i) Rendered perfusion services to a patient while
under the influence of alcohol or any controlled substance or in any impaired
mental or physical condition.

(j) Practiced perfusion after his or her license as
a perfusionist had expired or been revoked or suspended.

(k) Has been convicted of a felony, any offense
involving moral turpitude or any offense relating to the practice of perfusion
or the ability to practice perfusion.

(l) Has had a license to practice perfusion
revoked, suspended, modified or limited by another state or jurisdiction or has
surrendered such a license or discontinued the practice of perfusion while
under investigation by any licensing authority, a medical facility, a branch of
the Armed Forces of the United States, an insurance company, an agency of the
Federal Government or any employer.

(m) Engaged in any sexual activity with a patient
who was being treated by the perfusionist.

(n) Engaged in disruptive behavior with physicians,
hospital personnel, patients, members of the family of a patient or any other
person if the behavior interferes with the care of a patient or has an adverse
impact on the quality of care rendered to a patient.

(o) Engaged in conduct which brings the profession
of perfusion into disrepute, including, without limitation, conduct that
violates any of the following ethical guidelines:

(1) A perfusionist shall at all times hold the
well-being of his or her patients paramount and shall not act in such a way as
to bring the interests of the perfusionist into conflict with the interests of
his or her patients.

(2) A perfusionist shall not engage in conduct
that violates the trust of a patient and exploits the relationship between the
perfusionist and the patient for financial or other personal gain.

(3) A perfusionist shall not delegate licensed
responsibilities to a person who is not qualified to perform those
responsibilities.

(p) Engaged in sexual contact with a surrogate of a
patient or with any person related to a patient, including, without limitation,
a spouse, parent or legal guardian of a patient, that exploits the relationship
between the perfusionist and the patient in a sexual manner.

(q) Made or filed a report that the perfusionist
knew to be false, failed to file a record or report as required by law or
willfully obstructed or induced another person to obstruct any such filing.

(r) Failed to report to the Board any person that
the perfusionist knew, or had reason to know, was in violation of any provision
of this chapter or chapter 630 of NRS
relating to the practice of perfusion.

(s) Has been convicted of a violation of any
federal or state law regulating the prescription, possession, distribution or
use of a controlled substance.

(t) Held himself or herself out or permitted
another person to represent the perfusionist as a licensed physician.

2. A person who has been licensed as a
perfusionist by the Board but is not currently licensed, has surrendered his or
her license or has failed to renew his or her license may be disciplined by the
Board upon hearing a complaint for disciplinary action against the person.

1. If the Board or any investigative
committee of the Board has reason to believe that the conduct of any
perfusionist has raised a reasonable question as to his or her competence to
practice as a perfusionist with reasonable skill and safety to patients, the
Board or investigative committee may order that the perfusionist undergo a
mental or physical examination or an examination testing his or her competence
to practice as a perfusionist by physicians or any other examination designated
by the Board or investigative committee to assist the Board or investigative
committee in determining the fitness of the perfusionist to practice perfusion.

2. Every perfusionist who applies for or is
issued a license and who accepts the privilege of performing perfusion services
in this State shall be deemed to have given consent to submit to an examination
pursuant to subsection 1 if directed to do so in writing by the Board or
investigative committee.

3. For the purpose of this section, the
report of testimony or examination by the examining physicians does not
constitute a privileged communication.

4. Except in extraordinary circumstances, as
determined by the Board, the failure of a perfusionist to submit to an
examination if directed to do so pursuant to this section constitutes an
admission of the charges against the perfusionist. A default and final order may
be entered without the taking of testimony or presentation of evidence.

5. A perfusionist who is subject to an
examination pursuant to this section shall pay the costs of the examination.

1. The Board will appoint three
perfusionists to an advisory committee. To the extent practicable, each
appointee must have lived in and actively and continuously practiced perfusion
in this State for at least 3 years before his or her appointment.

2. The Board will give each appointee
written notice of his or her appointment and term of office and a written
summary of any projects pending before the advisory committee.

3. At the request of the Board, the advisory
committee shall review and make recommendations to the Board concerning any
matter relating to perfusionists.

(Added to NAC by Bd. of Medical Exam’rs by R079-10,
eff. 12-16-2010)

SUPERVISION OF MEDICAL ASSISTANTS

NAC 630.800“Delegating practitioner” defined. (NRS
630.130, 630.138)As used
in NAC 630.800 to 630.830,
inclusive, unless the context otherwise requires, “delegating practitioner”
means a person who is licensed as a physician or physician assistant and who
delegates to a medical assistant the performance of a task pursuant to the
provisions of NAC 630.810 or 630.820.

1. A delegating practitioner may delegate to
a medical assistant the performance of a task if:

(a) The delegating practitioner knows that the
medical assistant possesses the knowledge, skill and training to perform the
task safely and properly;

(b) The medical assistant is not required to be
certified or licensed to perform that task; and

(c) The medical assistant is employed by the
delegating practitioner or the medical assistant and the delegating
practitioner are employed by the same employer.

2. Except as otherwise provided in NAC 630.820, if a medical assistant is delegated a
task which involves an invasive procedure, the delegating practitioner must be
immediately available to exercise oversight in person while the medical
assistant performs the task.

1. A delegating practitioner may supervise
remotely a medical assistant to whom the practitioner has delegated the
performance of a task if:

(a) The patient is located in a rural area;

(b) The delegating practitioner is physically
located a significant distance from the location where the task is to be
performed;

(c) The delegating practitioner determines that the
exigent needs of the patient require immediate attention;

(d) The patient and the delegating practitioner
previously established a practitioner-patient relationship; and

(e) The delegating practitioner is immediately
available by telephone or other means of instant communication during the
performance of the task by the medical assistant.

2. As used in this section, “rural area”
means any area in this State other than Carson City or the City of Elko,
Henderson, Reno, Sparks, Las Vegas or North Las Vegas.

(Added to NAC by Bd. of Medical Exam’rs by R094-12,
eff. 2-20-2013)

NAC 630.830Prohibited activities by delegating practitioner. (NRS 630.130, 630.138)A
delegating practitioner retains responsibility for the safety and performance
of each task which is delegated to a medical assistant. A delegating
practitioner shall not:

1. Delegate a task that is not within the
authority, training, expertise or normal scope of practice of the delegating
practitioner;

2. Transfer to another physician or
physician assistant the responsibility of supervising a medical assistant
during the performance of a task unless the physician or physician assistant
knowingly accepts that responsibility;

3. Authorize or allow a medical assistant to
delegate the performance of a task delegated to the medical assistant to any
other person; or

4. Delegate or otherwise allow a medical
assistant to administer an anesthetic agent which renders a patient unconscious
or semiconscious.